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INDEX/SECTION B TRENDS Monday, September 16,1985 Section B Surgery By Mark Smith Herald staff writer ~ For years, people sufferiuflrom poor eyesight had no choice but to turn I > eyeglasses for improved v|jnon. In the 1960s, hard contact lenses were in commc i use, freeing people fropn eyeglasses for the first time. Soft contacts hit tl ; market in the '70s, Miowed ok oxygen permeable lenses and extended wet r lenses in the '80s. 5jsch was an Approvement from its predecessor, yet they s 1 stiljl had drawback At about the swne time extended v9kr lenses were making their debut, woi 1 was just reachWfg the United States of a\ew surgical procedure that for the fir t time could eliminate the need for correctivlteveware altogether. The creatyn of the procedure, called radiaUceratotomy (RK), is attributed ) Prof. Svyamoslav Fyodorov of the Soviet Uniffl^n 1972. By now most eyegla 5 wearers h/re at least heard the name, but many sHu do not know much about tl e \ or if it would work for them. Radialfkeratotomy is only effective for nearsighted p&SDle. Nearsightedness, r Myopia/is the most common vision disorder and is uflkresult of the corne 1 curvatyre of the eye being too high. The cornea, the fronr^lear portion of tne eye, nfrmally focuses incoming light waves on to the retina\r back of the eye (Figule 1). In the case of nearsighted people, the high curvatulg of the cornea result in the light waves being focused in front of the retina, not on it, which cause distant objects to appear blurred (Figure 2). In RK surgery, incisions are made in the cornea with a diamond-tipped knife. The luts are made in a radial pattern, like the spokes of a wheel, from about the centf* of the eye to just short of the white portion of the eye. As the incisions heal, the (ynlWr TJR the retina (Figure 3). Ev varying the placement and depth of the incisions, the ophthalmologist is able (ontrol the amount of flattening and thus the amount of correction. A nsser known procedure, myopic keratomileusis (MKM), is also sometimes used lp correct nearsightedness. In this procedure, a small wafer section, called a lenflcle, is cut out of the front of the cornea. The lenticle, slnUjfer in size to a hard ®ntact lens, is then frozen and put on a computer-guid^nathe. The lathe gently shaves the lenticle down to a predetermined size aq^shape, and onc^it has thawed, it is sutured back into place. The my to this procedure is the computer-guide^flathe that allows fie ophthalmologist to control precisely how much channels made in the curvati re of the cornea. In most cases, a donor cornea ISJIBO kept on hand, should i le section of tke patient's cornea be unusable for whenever reason. In each tjbe of operation, the patient is e^neraliy wily sedated, so they j re conscious dumg the operation. A local anejjnetic is used on the eye so the pati nt does not feel aw pain, and in most cases^mere is no bleeding. Radial keratotomy surgery typical only takes about 20 minutes, wl le 'keratomileusis cab take up to 45 jpmutes. In both procedures, only one ey< is done at a time, amrUiere is a waging period between the two operations, to mfce sure the first eye is naming pr_ Ttor for which procedure is used, if any, is how lad is. On a patient's eyeware prescription there re flindrical and axis. Under the spherical head rag and "OS." The right eye is the OD, or oci us dexter, measurement and the leftae is the OS, or oculus sinister, measuremi it. A negative sign in front of these rlhmbers indicates nearsightedness and he number itself represents the degree of nehsaghtedness in diopters. Hie other measurements, cylindrical andaM^efer to the amount of astig! la- tism the patient has and its alignment. AstigmanSa^Jsthe condition where he focal point of incoming light waves, the point mlii n fflT wiilihl 1111 in focu# is The primary deter the patient's nearsightc three measures: spherical? there are two measurements,' eglasses, contacts of astigmatism is caused by the front jrical, but rather slightly oval, like the wins and degrees of astigmatism, procedure, and the correction }cy poorly-formed. The most curve of the cornea not being back of a spoon. Both RK and MKM can correct for sonil but certain forms gannot be corrected by ei" may not always be complete. "Outpatient Surgery to Lessen Eyegl talk by Robert L. Epstein, M.D., a Jftding oph corrective eye surgery. The seminaawll be preseni Medical Center on Thursday, SeptjC at 2 p.m. According to Epstein, radial JWratotomy is generally one to six diopters of nearsiswedness, while myopic keral the five to 16 diopters ranga^Epstein warns, though, that j vision may be in those jinges, he or she is not automati surgery. "You've got to haufa problem to solve," Epstein said. "The done to alleviate ^problem. It's not a panacea." n Epstein saidmt uses an in-depth screening process to choose nilcandldates for surgery. Though the screening, he determines the patients' physical qualifica tions for jm operation, and also his or her motives for wanting the operation Part of JRe screening, he said, is that all of the alternatives to surgfcry must first be thoroughly explored, including eyeglasses and contacts. "If you can wear contacts all day, then you're not a^andidAe," Epstein explained. "But if you can only wear them a few hours before taking hem out, or if you have to use drops a lot, then you might be a candidate. Somefne who just heard about the auraerv. and decided thev wanted It la alan dot candidate. will be the subject of a lologist in the field of at the Northern Illinois ve for people with mileusis is used for use a patient's a candidate for gery should be iltely not a for having I reman and That means not qualify is about to bad and he studying all Epstein feels that a vocational need is one of the best reason] corrective eye surgery. In some professions, such as policeman, pilot, a person must have un-aided vision, within a certain range that a person could have 20/20 vision with glasses or contacts, and s to workin those professions. "Say nmeone has been studying criminology for three years graduate,'Epstein said. "But during that time his eyes have needs glasse^That means he couldn't work as a policeman that time. That person would be a good candidate for the surgery "But say someone else comes in who can wear contacts withfno problem and has no vocational neMJor the surgery. Let's make them extended wear contacts even. There is no way remld touch that man's eyes. It's just Convenience." Epstein added that in extreme cases, the decision whethei/o operate or not is fairly easy -- it's the gray afeaa in-between that's the problem He explained that he normally presents the dataVid information to his patipts, they talk about it, and they jointly agree on the finaMecision Even though the average personlttaring eyeware wAld give almost anything to have perfect, unaided vision; mo^are still v^jfy apprehensive about the thought of someone cutting into their ey "When someone is not leery of the operaHn, thpff I worry," Epstein said. Epstein is quick to point out that the risk involved in the surgery is not that great. He explained that what a patient considers to be a risk can depend on what he or she expects from the operation. Ifa^Tatient expects to have perfect vision after the operation, then less than pertoovislon could be considered a risk, or the need for a secondoperation couldlprome a risk. "Satisfaction has a lot to dj^mh the patient's perception of what I can do for them," he said EYE SURGERY- page 3B noune 1; Normal Cyo mow 2: Myopic Cye flM#U IMP H a |A >rtn|f AyA gimgAay nw* ii i vyvjm. vy« mum vwgpy wnginptcoi the PEOPLE TALK Ring of stars Semiflnallsts named t'KI The Princess of Wales made an Festival Hall last woek where she Prince uttfiHH the Music Society's Silver Jubilee sue, accompanied DV ner oust English Chamber Orchestra Gala concert at the Royal bar husband and C-SCALE tries saving cash for cable, satellite viewers Millions of satellite dish owners may be forced to spend from 8200 to $1,000 or more (or descrambling equipment to protect their TV view ins habits as current trends ins hat indicate Main entrance, lot closed at Good Shepherd Hospital The main entrance and visitor parking lot at Good Hospital, Barrington is porarily due to construction. The east entrance and a large portion of visitor parking lot B, in froot of the hospital will be closed through Sept. 27 Roadway improve­ ments are being done in those Traffic to the hospital is being rerouted through the new Doctors'. Office Buildings' entrance road on the west side of the hospital's cam­ pus Directional signs are posted Persons being admitted or dis­ charged from the hospital should use the upper lobby entrance of the building Visitors' parting is avail­ able in lot A, west of the hospital; lot C, just east of the emergency department and part of lot B These same satellite dish owners may have to spend an additional 1500 to 11,000 or more per year in rental fees to supplement the cost of the descrambler equipment that they were forced to obtain TV cable system subscribers may be in the same boat as the satellite dish owners as their monthly charges will begin to skyrocket to meet the added costs to the cable systems The cable systems will have to fty more to have the programs de- scrambled. nd then Miss the added subscribers These ad to the cable system* could add from tio to SS or more to their monthly bills O SCALE 'Citizen* Satellite CaMe cost to their League) Is s clUzen's action group that has undertaken the responsible My of bringing together the satellite dish owners and cable system sub scrtbers (or a common purpose Through extensive rasearcn and in tensive evaluation CSCALE and its members will be asaurad that any Increase in monttily rharges or rent afts will be reasonable C-SCALK it dedicated to praserv ing end protecting the legal rights of both the satellite die* owner and the cable system tutocribert from be ing arbitrarily <1>arg*d esceseive amount* lor any cost I rrreaaes Currently, there is no ettiaen ac Man organize*ton thai represents a0 of the satellite diafc owner* and ta­ ble systems subset**™ for more information on C* V.'ALK readers may send a self addressed, stamped envelope to C ftf'ALC Hff. See ». Ogm, ii mv Johnny Cash went to a Nashville television station Wednesday to visit his friend Dan Rather 4nd took along another fan of the CBS anchor­ man, Waylon Jennings. Cash said he wanted to visit Rather "for myself. It's my 2lst birthday. Twenty-one months today without drugs and I thought it was a perfect way to celebrate." Jennings said he came along because he's a news freak. "My son, Shooter, and I are always fighting over the cartoons or Dan Rather," he said. Rather, who met Cash while he was covering the White House for CBS, confided that Cash's "Ring of Fire" was his background music in a '47 Ford when he was courting his wife in the 1960s. "You've got to remember, it was Texas," said Rather, who was in town to speak to the Radio and Television News Directors Association. Rather said he was going through a libel trial in 1963 when Cash gave him a big lift by sending "the nicest note of support and encouragement." Undercover kissing Model Paulina Porizkova, the star of the Sports Illustrated swimsuit issue, often ha6 bad things to say about the people she runs across in her profession. At 15 the Czechoslovakian-born model said she went to a party in Paris and found she and a girlfriend were the only females among a group of ill-intentioned men. In the October issue of Glamour, Porizkova says she and her friend got through the evening by "sitting in a corner and kissing, pretending we were not really into guys. Just a little bit of humor, intelligence and dignity and you get along fine." Piscopo for Passaic Comedian Joe Piscopo will help his hometown, Passaic, N.J., rebound from the Labor Day fire that devastated an industrial neighborhood, leaving hundreds homelesslind jobless. Piscopo will be part of the New Jersey All-Star Show that also will feature Bruce Springsteen cohorts South Side Johnny and the Asbury Jukes and "Little Steven" Van Zandt. Profits from the Sept. 20 show will go to the relief agencies helping the victims of the inferno. After being approached about putting on a Passaic benefit, concert promoter John Scher called Piscopo. "It took Joe a minute to say yes," he said One of the buildings destroyed in the fire was a warehouse holding 10,000 costumes for the New York City Opera, Including those for the 1986 season. Beverly Sills is heading the drive to raise $5 million to replace the costumes, some of which she wore for performances. Glimpses Some of the contestants in the Miss America contest are descended from the famous. The mother of Miss Missouri, Lisa Coverdale, is Miss Norma of television's "Romper Room" and Miss Georgia, Ssmsnths Mohr, says she is a descendant of Joseph Mohr, who wrote the lyrics to "Silent Night" ... Prince Charles will go to Texas in February to celebrate the state's 150th anniversary of independence from Mexico and to present the Winston Churchill Award to Dallas computer mag­ nate H. Ross Perot. "It's very kind of him to come," Perot said. "I appreciate the fact that he would take the trouble to come over" ... Wayne Newton's brother, Jerry, was indicted in Nashville for Iftng in order to receive a $500,000 Small Business Administration loan in 1960. Newton put-the money toward his personal use after telling the SBA it would go toward paying off debts. Newton, a former director of the Traders National Bank in Tullahoma, also faces charges of misapplying more than $500,000 in bank funds for his own use through improper loans for merit scholarships Several area students were among 15,000 high school seniors nsmed Sept. 11 as semiflnallsts in the 31st annual Merit Program. National Merit Scholarship Corporation (NM8C), which conducts the cbmpetlUon, publicly recognizes the select group of students In order to honor their academic talents and broaden their higher education Trtunities. ) miflnalists have completed the first step In the compeUtlon (or about 5,800 Merit scholarships, worth nearly $21 million, to be awarded next spring. Students entered the competition by taking a qualifying tost, the PSAT/NMSQ, In October, 1964. Less than hai( o( one percent o( each state's high school senior class are Included in the nationwide group of semiflnallsts. Area semiflnallsts, their schools, and their Intended careers, are as follows: Algonquin, from Harry D. Jacobs High 8chool: Christopher C. Harvey, journalist/writer. Barrington, from Barrlnston Consolidated High School: John S. Hotter- kamp, physician; TheresaS. Jordan, undecided; Ralph W. Schott, undecid­ ed; Stephen A. Wldmar, engineer; Mary E. Zlmmer, lawyer Crystal Lake, from Crystal Lake Central High School: Andrew B. Coxhead, lawyer; Marianne J. Potje, musician. Elgin: (rom Elgin Academy, Eugene C. Kim, physician; (rom Elgin High School, Thomas C. Jones, undecided and Michael D. Lake, mathematician or staUsUcian; (rom St. Edward Central Catholic High School, Susan M, Kessel, undecided; (rom Larkin High School, Jeff M. Can field, undecided, C. Scott Davis, nuclear engineer, Dean G. Menties, engineer, Tracy J Michniewtcz, forester, conservationist, and Wendy R Welsh, health (told McHenry: from McHenry High School West Csmpus, Joan M. Marchese, journalist/writer. Woodstock: from Woodstock High School, Jeffrey E. Poehlmann, journalist/writer. To advance In the Merit scholarship competition, a semifinal 1st muet qualify as a finalist by documenting high academic performance, being recommended by the high school principal, confirming qualifying tost performance on the Scholastic Aptitude Test, and submitting information about school and community activities, personal Interests and goals, Over 90 percent (or 13,500) of the semiflnallsts In this year's Merit Program are expected to meet the standards required to become finalists Over 40 percent of the finalists will be swarded Merit scholarships of three different types. - NMSC Is a not-for-profit organization devoted solely to scholarship activities that are supported by more than 600 Independent sponsors, without federal or state (unds The Merit scholar class, to be announced in the spring of 1916, will join over 90,000 other academic champions who have received Merit scholarships worth about MS million between I9S6 and iSSI Debate partner wanted Anyone who would like to debate anti-ERA crusader Phyllis Schlafly should contact the Wyoming chapter of her organization, the American Eagle Forum. Schlafly Is scheduled to appear at a forum conference In Casper Sept. 28 and the local president, Gwen Hamilton, says the liberal elements are afraid to take her on. "We are merely trying to present both sides of the issue," she said. Those declining the chance to go mouth-to-mouth with Schlafly include a state representative who didn't think she would get a fair chance, another legislator who said his opinions did not conform with those of the Eagle Forum and an editorial writer for the Casper Star-Tribune who said he had a family 'commitment.